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Ogilvie's syndrome presented with delirium in an older lady with corticobasal syndrome

Published online by Cambridge University Press:  05 July 2021

Feyza Mutlay ,
Derya Kaya Open the ORCID record for Derya Kaya [Opens in a new window]  and
Ahmet Turan Isik
Feyza Mutlay
Affiliation:
Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
Derya Kaya
Affiliation:
Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
Ahmet Turan Isik*
Affiliation:
Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
*
Author for correspondence: Ahmet Turan Isik, Unit for Brain Aging and Dementia, Department of Geriatric Medicine, School of Medicine, Dokuz Eylul University, 35340 Izmir, Turkey. E-mail: atisik@yahoo.com
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Abstract

Objective

Corticobasal syndrome (CBS) is one of an atypical parkinsonian syndromes characterized by extrapyramidal features as well as cortical involvement signs. A variety of factors may lead to delirium in older adults with chronic progressive life-limiting neurological illnesses like CBS. Ogilvie's syndrome (OS) is an acute colonic pseudo-obstruction in which abdominal distension, nausea, vomiting, and constipation can be seen. We report a case of OS identified as the underlying possible cause of delirium in an 80-year-old woman with CBS. We also discuss the importance of holistic approach which is essential to manage the underlying cause and to preserve the quality of life in particular for the frail geriatric population who potentially needs palliative care or already benefits from palliative care.

Method

An older patient with CBS presented with symptoms similar to that of acute colonic obstruction and subsequently developed delirium. The patient was found to have colonic pseudo-obstruction (OS).

Result

Neostigmin infusion was therefore given to treat it and delirium was resolved.

Significance of results

To the best of our knowledge, clinical manifestation of delirium as OS in a patient with CBS has not been previously reported. OS may be superimposed to CBS in older patients, and OS in such patients may play a role as a precipitating factor for the development of delirium. Given the fact that CBS is progressive and rare neurodegenerative disease and almost all of these patients need palliative care, eventually, health-care professionals, especially in palliative care, should be aware of distinctive challenges of life-limiting chronic neurological illnesses, such as conditions that may lead to the development of acute colonic pseudo-obstruction because the rapid treatment of them prevents the use of potentially harmful drugs, surgical procedures, or inappropriate interventions.

Keywords

Corticobasal syndromeDeliriumElderlyOgilvie's syndromePalliative care
Type
Case Report
Information
Palliative & Supportive Care , Volume 19 , Issue 5 , October 2021 , pp. 631 - 633
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Ates Bulut, E, Soysal, P and Isik, AT (2018) Frequency and coincidence of geriatric syndromes according to age groups: Single-center experience in Turkey between 2013 and 2017. Clinical Interventions in Aging 13, 1899–1905. doi:10.2147/CIA.S180281CrossRefGoogle ScholarPubMed
Bükki, J, Nübling, G and Lorenzl, S (2016) Managing advanced progressive supranuclear palsy and corticobasal degeneration in a palliative care unit: Admission triggers and outcomes. The American Journal of Hospice & Palliative Care 33(5), 477–482. doi:10.1177/1049909114565110CrossRefGoogle Scholar
Conner, S, Nassereddin, A and Mitchell, C (2020) Ogilvie syndrome. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK526102/?report=classic.Google Scholar
Deutschländer, AB, Ross, OA, Dickson, DW, et al. (2018) Atypical parkinsonian syndromes: A general neurologist's perspective. European Journal of Neurology 25(1), 41–58. doi:10.1111/ene.13412CrossRefGoogle ScholarPubMed
Isik, AT, Kolukisa, M, Ergun, F, et al. (2013) Ogilvie's syndrome in an elderly patient with multi-system atrophy. Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society 23(3), 155–156. doi:10.1007/s10286-013-0192-zCrossRefGoogle Scholar
Jain, A and Vargas, HD (2012) Advances and challenges in the management of acute colonic pseudo-obstruction (ogilvie syndrome). Clinics in Colon and Rectal Surgery 25(1), 37–45. doi:10.1055/s-0032-1301758Google Scholar
Jetmore, AB, Timmcke, AE, Gathright, JB Jr, et al. (1992) Ogilvie's syndrome: Colonoscopic decompression and analysis of predisposing factors. Diseases of the Colon and Rectum 35(12), 1135–1142. doi:10.1007/BF02251964CrossRefGoogle ScholarPubMed
Ogilvie, H (1948) Large-intestine colic due to sympathetic deprivation; a new clinical syndrome. British Medical Journal 2(4579), 671–673. doi:10.1136/bmj.2.4579.671CrossRefGoogle ScholarPubMed
Ponec, RJ, Saunders, MD and Kimmey, MB (1999) Neostigmine for the treatment of acute colonic pseudo-obstruction. The New England Journal of Medicine 341(3), 137–141. doi:10.1056/NEJM199907153410301CrossRefGoogle ScholarPubMed
Turégano-Fuentes, F, Muñoz-Jiménez, F, Del Valle-Hernández, E, et al. (1997) Early resolution of ogilvie's syndrome with intravenous neostigmine: A simple, effective treatment. Diseases of the Colon and Rectum 40(11), 1353–1357. doi:10.1007/BF02050822CrossRefGoogle ScholarPubMed
Vanek, VW and Al-Salti, M (1986) Acute pseudo-obstruction of the colon (ogilvie's syndrome). An analysis of 400 cases. Diseases of the Colon and Rectum 29(3), 203–210. doi:10.1007/BF02555027CrossRefGoogle ScholarPubMed
Wiblin, L, Lee, M and Burn, D (2017) Palliative care and its emerging role in multiple system atrophy and progressive supranuclear palsy. Parkinsonism & Related Disorders 34, 7–14. doi:10.1016/j.parkreldis.2016.10.013CrossRefGoogle ScholarPubMed